Clinician's Digest


Clinician's Digest

Battling the Opioid Epidemic in Rural America

May/June 2017


It had been an otherwise uneventful day when Elizabeth Zeinner, a 24-year-old EMT, received a phone call one summer afternoon in 2009, interrupting a lunch study session for her upcoming paramedic science exams. “He’s unconscious,” a colleague radioed in. “That’s all the info we’ve got.” With another first responder, she boarded an ambulance and braced herself as it streaked past a string of rundown houses. She booted up a cardiac monitor and double-checked her Narcan detox kit, taking deep, slow breaths—a technique that had served her well for the two years she’d been working in Bartholomew County, a poverty-stricken region on Indiana’s eastern border. She’d treated everything from strokes to fractured hips, but it was the first time she’d encountered an opioid overdose.

“Grab the trauma bag!” the other paramedic called out as the ambulance came to a stop outside a small house crowded by frantic neighbors. Inside, an unresponsive man had passed out on his bedroom floor—pale, barely breathing, his heartbeat nearly undetectable. The culprit: a prescription Fentanyl painkiller patch, hardly larger than a Post-It note, but 100 times as powerful as morphine. Zeinner carefully placed a needle in the man’s arm, and waited. She ushered the bystanders out of the room. “We’re here to take care of him,” she told them. “We’ll give you an update on his progress as soon as we can. I promise. Trust me.”

The man bolted upright as the Narcan that Zeinner had injected took…

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